ABSTRACT
Successful surgical repair of the unilateral cleft lip and nose deformity, defined
as normal orbicularis oris function and near-perfect symmetry of the repaired lip
and nose, demands that the surgeon possess complete understanding of the embryology
and anatomy of the midfacial defects. The surgical approach to repair of the unilateral
cleft lip/nose should place great emphasis on achieving symmetry, not only with the
lip segments but also perhaps even more importantly with the nasal tip. The reconstruction
should recreate an intact fully functional orbicularis oris muscle across the cleft
and camouflage the scar optimally. We have found that modification of the Millard
rotation-advancement flap technique, with particular attention to the primary nasal
repair, provides the best outcomes. In patients who have undergone primary repair
of the lip and/or nose deformity, secondary rhinoplasty is generally required, regardless
of the technique used at the primary repair. The degree of nasal deformity, however,
is less severe following primary repair of the asymmetric nasal tip. We have found
that the sliding flap cheliorhinoplasty, Wang's modification of the Vissarionov technique,
provides excellent results for most secondary cleft rhinoplasties.
KEYWORDS
Cleft lip - cleft nasal deformity - secondary cleft rhinoplasty - sliding flap cheliorhinoplasty
